At present tattoos and piercings can no longer be regarded as destructive acts of self mutilation practized by fringe groups. Body modifications (BMs) are found in virtually all preindustrial cultures and have their roots in ancient myths and magical rituals. The prevalence of tattoos and piercings in the German population is 8.5% and 6.8%, respectively. Unemployed young men and young women who do not live in a firm partnership show particularly high prevalences. The incidence of BMs correlates positively with the personality trait "sensation seeking", particularly in young women. BMs often serve to express individuality and identity, and they also reflect changed attitude towards the human body and body art as well as following fashion trends. However, BMs can also provide valuable diagnostic indications for identity search and risk taking behaviour.